Abstract

BackgroundAutism spectrum disorder (ASD) traits are continuously distributed throughout the population, and ASD symptoms are also frequently observed in patients with attention-deficit/hyperactivity disorder (ADHD). Both ASD and ADHD have been linked to alterations in reward-related neural processing. However, whether both symptom domains interact and/or have distinct effects on reward processing in healthy and ADHD populations is currently unknown.MethodsWe examined how variance in ASD and ADHD symptoms in individuals with ADHD and healthy participants was related to the behavioural and neural response to reward during a monetary incentive delay (MID) task. Participants (mean age: 17.7 years, range: 10–28 years) from the NeuroIMAGE study with a confirmed diagnosis of ADHD (n = 136), their unaffected siblings (n = 83), as well as healthy controls (n = 105) performed an MID task in a magnetic resonance imaging (MRI) scanner. ASD and ADHD symptom scores were used as predictors of the neural response to reward anticipation and reward receipt. Behavioural responses were modeled using linear mixed models; neural responses were analysed using FMRIB’s Software Library (FSL) proprietary mixed effects analysis (FLAMEO).ResultsASD and ADHD symptoms were associated with alterations in BOLD activity during reward anticipation, but not reward receipt. Specifically, ASD scores were related to increased insular activity during reward anticipation across the sample. No interaction was found between this effect and the presence of ADHD, suggesting that ASD symptoms had no differential effect in ADHD and healthy populations. ADHD symptom scores were associated with reduced dorsolateral prefrontal activity during reward anticipation. No interactions were found between the effects of ASD and ADHD symptoms on reward processing.ConclusionsVariance in ASD and ADHD symptoms separately influence neural processing during reward anticipation in both individuals with (an increased risk of) ADHD and healthy participants. Our findings therefore suggest that both symptom domains affect reward processing through distinct mechanisms, underscoring the importance of multidimensional and multimodal assessment in psychiatry.Electronic supplementary materialThe online version of this article (doi:10.1186/s13229-015-0043-y) contains supplementary material, which is available to authorized users.

Highlights

  • Autism spectrum disorder (ASD) traits are continuously distributed throughout the population, and ASD symptoms are frequently observed in patients with attention-deficit/hyperactivity disorder (ADHD)

  • Participants with ADHD were of similar age compared to their siblings and healthy controls (ADHD vs SIBS t217 = 1.33, p = 0.186; ADHD vs CON t239 = 1.35, p = 0.179); unaffected siblings were older than controls (SIBS vs CON, t186 = 2.32, p = 0.022)

  • Scores on the CPRS-R-L were highest for ADHD, as expected (ADHD vs SIBS, t217=16.58, p < 0.001; ADHD vs CON, t239 = 20.47, p < 0.001), but were elevated in siblings compared to controls (SIBS vs CON, t186 = 2.75, p = 0.007)

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Summary

Introduction

Autism spectrum disorder (ASD) traits are continuously distributed throughout the population, and ASD symptoms are frequently observed in patients with attention-deficit/hyperactivity disorder (ADHD). Both ASD and ADHD have been linked to alterations in reward-related neural processing. Whether both symptom domains interact and/or have distinct effects on reward processing in healthy and ADHD populations is currently unknown. ADHD, a neurodevelopmental disorder characterized by inattentiveness and/or hyperactivity and impulsivity, has been associated with high ASD comorbidity and elevated levels of ASD symptoms compared to the general population [5,6,7]. How the two symptom domains interact in their effects on cognition, remains largely unknown

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